Three-Dimensional Quantitative Volumetry of Chronic Total Occlusion Plaque Using Coronary Multidetector Computed Tomography

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概要

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• Background: The purpose of the present study was to investigate whether multidetector computed tomography (MDCT) can identify the nature of chronic total occlusion (CTO) plaque, which cannot be measured quantitatively using traditional coronary angiography, and predict the success of percutaneous coronary intervention (PCI). Methods and Results: MDCT and 3-dimensional volumetric radiologic density analysis was performed for 186 consecutive CTO lesions. Plaque characteristics were determined using Hounsfield units (HU) of the image voxels. The remodeling index decreased significantly as the duration of CTO lengthened. Volumetric plaque analysis using HU showed that volumetric fraction of calcification (>324HU) did not, but low-density plaque (<49HU) did decrease significantly as the duration of CTO lengthened. The overall PCI success rate was 77.4% (144/186). In addition to the unknown or >12-month occlusion duration (odds ratio [OR]=3.0, 95% confidence interval [CI]=1.4-6.5, P=0.005), 2 MDCT parameters, that is, lesion length >18mm (OR=2.7, 95%CI=1.1-6.4, P=0.024) and segmental radiologic density >139HU (OR=2.7, 95%CI=1.2-6.4, P=0.021), were independent predictors of PCI failure on multivariate analysis. Conclusions: MDCT might be helpful for the prediction of successful CTO PCI. In addition to the occlusion duration, lesion length and high segmental radiologic density measured on MDCT were significant predictors of PCI failure in the present study. (Circ J 2011; 75: 366-375)

• 2011-01-25

著者

• Jang Yangsoo

  Department Of Cardiology Yonsei University College Of Medicine

• Choi Jin-ho

  Sungkyunkwan University School Of Medicine Samsung Medical Center Department Of Emergency Medicine

• CHO Jung

  Department of Chemical Engineering, Konkuk University

• SONG Young

  Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine

• Choi Jin-Ho

  Department of Emergency Medicine, Cardiac and Vascular Center, Cardiovascular Imaging Center, Samsun

• Hahn Joo-Yong

  Department of Medicine, Cardiac and Vascular Center, Cardiovascular Imaging Center, Samsung Medical

• Choi Seung

  Department of Medicine, Cardiac and Vascular Center, Cardiovascular Imaging Center, Samsung Medical

• Gwon Hyeon-Cheol

  Department of Medicine, Cardiac and Vascular Center, Cardiovascular Imaging Center, Samsung Medical

• Choe YeonHyeon

  Department of Radiology, Cardiac and Vascular Center, Cardiovascular Imaging Center, Samsung Medical

• Choi Jae

  Department Of Medicine Sungkyunkwan University School Of Medicine Samsung Medical Center

• Yang Jeong

  Department Of Medicine Cardiac And Vascular Center Sungkyunkwan University School Of Medicine Samsun

• Choi Jin-oh

  Samsung Medical Center Sungkyunkwan University School Of Medicine Republic Of Korea

• Choi Jin-ho

  Department Of Computer Engineering Pusan University Of Foreign Studies

• Hahn Joo-yong

  Department Of Internal Medicine Cardiology Sungkyunkwan University School Of Medicine

• Yang Ju-young

  National Health Insurance Corporation Ilsan Hospital

• Choi Sung-hyuk

  Division Of Cardiology Department Of Medicine Samsung Medical Center Sungkyunkwan University School

• Song Young

  Division Of Cardiology Department Of Medicine Samsung Medical Center Sungkyunkwan University School

• Gwon Hyeon-cheol

  Division Of Cardiology Department Of Medicine Samsung Medical Center Sungkyunkwan University School

• Jang Yangsoo

  Yonsei University Severance Hospital

• Cho Jung

  Department Of Internal Medicine Gangnam Sacred Hospital Hallyum University School Of Medicine

• Gwon Hyeon-cheol

  Department Of Medicine Cardiac And Vascular Center Cardiovascular Imaging Center Samsung Medical Cen

• Choi Seung

  Department Of Applied Chemistry Konkuk University

• Song Young

  Department Of Animal Resources Technology Jinju National University

• Choe Yeonhyeon

  Department Of Radiology Cardiac And Vascular Center Cardiovascular Imaging Center Samsung Medical Ce

• YOON Jung-Han

  Wonju Christian Hospital

• Choi Jin-oh

  Cardiovascular Imaging Center Cardiac And Vascular Center Samsung Medical Center Sungkyunkwan Univer

• Cho Jung

  Department of Chemical Engineering, Kongju National University

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